In Canada, the dental plans provided by the government include very selective treatments.

Therefore, people have to take care of the cost either by themselves or with private insurance.

In any scenario, it is better to have an understanding of the bill. In that way, you will know the precise out-of-pocket cost and the treatments that are covered by your specific dental plan.

Familiarizing yourself with the dental procedure codes in Ontario is crucial for billing and reimbursement.

If you are all set for your trip to a dentist, this guide will help you learn about the dental procedure codes in Ontario to save yourself from overpaying.

Dental Procedure Codes in Ontario: Simple Definition

Dental services are categorized using the Canadian dental procedure codes.

The Canadian dentistry sector uses this special approach to maintain uniformity in its services throughout the nation.

The Canadian Dental Association (CDA) handles system development and regulation.

Each dental procedure has its own five-digit number. Canadian dentists use these codes to bill consumers, keep track of their services, and communicate within the dental community.

The Canadian dentistry sector is structured by the use of dental procedure codes in Ontario.

Canadian dentists wouldn't know precisely how to define or price the work they perform in the absence of a standardized framework.

Hence, dental procedure codes in Ontario enable dentists to standardize their work.

Dental procedure codes in Ontario also enable regulatory entities to control dental practices and the fees that dentists charge for various services.

Lastly, it gives insurance companies the flexibility to select the percentage of dental procedure costs that they will pay for.

Province to province, dentists use almost similar codes. However, Quebec employs a quite distinct coding scheme.

Overview of Ontario Dental Fee Guide 2024

The ODA's yearly fee guide may also have an impact on dental fees in Ontario.

For instance, if you compare the Ontario dental fee guide 2023 with the 2024 fee guide, you will see a slight increase in the prices.

The guide lists every dental procedure a dentist may perform, as well as recommended costs and Ontario procedure codes for each service.

The Ontario Dental Fee Guide 2024 can be used by dentists and dental plan providers as a resource to help determine appropriate service charges.

Dentists are not obliged to adhere to any pricing schedule or the guide. They determine their own rates in accordance with the variables affecting each practice.

That implies that the cost of visiting your dentist could be higher or lower than the Ontario Dental Fee Guide 2024.

Many dental plan providers will use the guide's costs and dental procedure codes in Ontario as the foundation for their plans' coverage.

Although paper copies of the ODA fee guide are available in the reference section of many public libraries, they are not available on the ODA website.

The guide includes more than 1,400 dental procedure codes in Ontario that correspond to dental procedures and use the terminologies common in dentistry.

This can be difficult for a patient to understand. Therefore, when you visit the dentist, you should ask about the estimated fee for every procedure they intend to perform on you.

Learn More: Dental Cleaning Cost: Average Cost of the Procedure

Factors Affecting the Dental Procedure Codes in Ontario

The cost of dental procedures can be affected by the many important aspects listed below:

1.Nature of the Treatment

The intricacy of the process is among the main contributing factors. More complex and specialized treatments often have a higher price tag because they require more sophisticated tools, time, and experience.

For instance, specialized medical care, such as dental transplants or intricate surgical operations, is typically more costly than standard dental cleanings or fillings.

2.Location of the Dental Clinic

Another important aspect is the dental practice's geographical location. The cost of living, local market competitiveness, and regional economic considerations can all substantially impact dental care prices.

Compared to dental offices in rural, those in urban areas may charge more for their services due to increased overhead costs.

3.Experience of the Professional

Variations in cost are also influenced by the degree of training and experience of the dentist doing the treatment.

Due to their particular knowledge and skill set, experienced specialists or dentists with unusual training and certifications may be able to charge more for their services.

4.Cost of Material Used

Moreover, the cost of dental procedures may be influenced by the supplies and equipment utilized.

As superior materials and cutting-edge technology can produce better results, they often come at a higher price.

For instance, there can be additional process costs if modern technology or high-end dental implants are used.

Dental Procedure Codes in Ontario: Three Categories

In the following section, there is a breakdown of the services in the most common categories:

1.Diagnostic Services

The dental procedure codes in Ontario for diagnosis or dental hygiene assessments start from 00100.

Primary (baby teeth): 00111

Mixed (When a child has both primary and permanent teeth): 00112

Permanent: 00113

Edentulous (Not having any teeth): 00114

Periodontal (gum disease assessment): 00115

Limited dental hygiene examination and diagnosis: 00120

Routine reassessment/recall (previous client): 00121

Emergency: 00123

Periodontal, limited, previous client: 00124

Specific (new or existing client): 00125

Limited (focused on a particular dental issue) for a new client: 00126

First dental hygiene visit/orientation: 00131

The code used for laboratory expenses is 00991, and the code for the added expense in the procedure is 00992.

Moreover, the time spent on the assessment and the circumstances of the treatment may increase the total cost.

The dental procedure codes in Ontario for images and radiographs used in diagnosis start from 00200 to 00279.

Tests & Laboratory Procedures: 00300

For tests needed for accurate diagnosis, the dental procedure codes in Ontario are as follows:

Caries susceptibility test: 00310

Bacteriological test: 00311

Periodontal disease activity test: 00320

Microbiological test: 00321

Oral Cancer Testing (Technical Procedure)

Oral cavity cytological smear (microscopic analysis): 00331

Oral mucosal tissue vital staining (a technique to stain living cells): 00332

Oral mucosal tissue direct fluorescence (for the detection of oral lesions): 00333

Non-ionizing Scanning Procedure (each unit of time is 15 minutes): 00340

1 unit of time: 00341

2 units of time: 00342

½ unit of time: 00347

Each additional unit of time >2: 00349

Study Models Required for Diagnostic Purposes: 00400

Impression(s) of maxilla and/or mandible: 00401

Fabrication/pouring/preparing casts for the study model:00402

2.Periodontal Treatments

The dental procedure codes in Ontario for periodontal treatments start from 00500.

Debridement (treatment of the wound by infection removal): 00510

From 00511-00516, the codes change with respect to the increase in unit of time from 1 to 6th.

½ unit of time: 00517

Each additional unit of time >6: 00519

Root Planing (deep cleaning for plaque and tartar removal): 00520

For 1 to 6th unit of time, the code is 00521 to 00526. Alternatively, for ½ unit of time, the code is 00527. Lastly, for each additional unit greater than 2 units, it is 00529.

Stain removal: 00530

1 unit of time: 00531

2 units of time: 00532

½ unit of time: 00537

Each additional unit of time >2: 00539

Subgingival Periodontal Irrigation (cleaning of the toxins beneath the gum line): 00540

1 unit of time: 00541

½ unit of time: 00547

Each additional unit of time: 00549

Management of Oral Mucosal Disorders: 00550

1 unit of time: 00551

2 units of time: 00552

3 units of time: 00553

4 units of time: 00554

½ unit of time: 00557

Each additional unit of time >4: 00559

Management of Oral Manifestation of Systemic Disease: 00560

1 unit of time: 00561

2 units of time:00562

3 units of time:00563

4 units of time:00564

½ unit of time: 00567

each additional unit of time >4: 00569

Gingival curettage (scrapping of the infested soft tissues from periodontal pockets: 00570

1 sextant: 00571

2 sextants: 00572

3 sextants: 00573

4 sextants: 00574

5 sextants: 00575

6 sextants: 00576

Sextant: One of the six equally sized parts of a dental arch, such as tooth numbers 1-5, 6 -11, 12-16, and so on.

Chemotherapeutic/Photodisinfection therapy (type of antibacterial and antimicrobial therapy): 00580

1 unit of time: 00581

½ unit of time:00582

Each additional unit of time: 00583

Other Oral Services (each unit of time is 15 minutes): 00600

Sealants: 00601

Application of anti-cariogenic/antimicrobial agents to hard tissues: 00605

Fluoride applications: 00610

Finishing restoration: 00620

Mouth protectors: 00630

Preformed – maxillary arch: 0061

Preformed – mandibular arch: 00632

Preformed – maxillary & mandibular arches: 00633

Custom – maxillary arch: 00634

Custom – mandibular arch: 00635

Custom – maxillary & mandibular arches: 00636

Labeling removable prosthesis: 00638

Desensitization (reduction of tooth sensitivity by strengthening the enamel): 00640

Whitening vital teeth in office: 00650

The dental procedure codes in Ontario for teeth whitening change till 00659, depending on the unit of time.

Whitening vital teeth at home: 00660

Maxillary arch (upper arch): 00661

Mandibular arch (lower arch): 00662

Maxillary and mandibular arches: 00663

Placement temporary restorations – must include tooth number(s) 00675

Resin infiltration (treatment for tooth discoloration): 00665

One surface: 00676

Each surface >1: 00677

Denture/removable prosthesis prophylaxis and stain removal: 00690

3.Pain Management

The dental procedure codes in Ontario for pain management start at 00700.

Electronic dental anesthesia (non-drug method of sedation): 00710

Local anaesthesia: 00720

Acupuncture: 00730

Nitrous oxide sedation: 00740

FAQs

How frequently are dental procedure codes in Ontario updated?

The ODA usually updates the codes for dental procedures every year to account for changes in procedures, expenses, and technology.

What should I do if a dental procedure code that I don't understand appears on my bill?

If a dental procedure code that you don't understand appears on your bill:

Request an explanation from the staff at your dentist's clinic.
For further details, get in touch with your dental insurance company.
For more information, see the ODA Suggested Fee Guide.

Do dental procedure codes apply to all Canadian provinces?

No, provincial codes for dental procedures can differ. Every dental association in a province has its own code system and pricing schedule.

In a Nutshell

Dental procedure codes in Ontario play a significant role in processing dental claims and maintaining accurate documentation.

Also, the dental procedure codes are helpful to your dentist in their professional capacity. They streamline their workflow and enable effective invoicing.

However, most of the dental clinics are private, and they may not follow the Ontario Dental Fee Guide for 2024.

If you don't want to pay a surprising amount for your dental work, contact a trustworthy dental clinic like KWC Dental.

Before getting a treatment, you can freely inquire about the charges and financing options. We work with utmost professionalism and transparency so that every patient leaves the clinic with a bright smile.

Dental Procedure Codes in Ontario 2024: How They Work